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Evidence-based Medicine (EBM) and Comparative Effectiveness Research (CER) are salient topics in healthcare. The evidence-based framework and terminology has been collectively applied to fields such as criminal justice, child welfare, behavioral health, and management (Sherman, 2002; Aarons & Palinkas, 2007; Rapp, Bond, Becker, Carpinello, Nikkel, & Gintoli, 2005; Rieckmann, Kovas, Fussell, & Stettler, 2008; Pfeffer & Sutton, 2006). The normative term evidence-based practice refers to interventions demonstrating a general level of accepted efficacy. The evidence-based framework provides a rational mechanism for evaluating and categorizing interventions by the level of supporting evidence. Expected products of this process include an increased clarity in the definition of best practices and a convergence of practices across providers. As a public policy, ensuring the use of evidence-base practices provides a potential rational method for controlling the quality of provider practices. In theory, provider use of evidence-based practices increases the quality of services provided and improves outcomes. The implementation of an evidence-based practice legislative mandate in the State of Oregon provided an opportunity to analyze the county-level implementation patterns of evidence-based practices and their impact on expected outcomes. This study sought to assess whether the implementation and outcome patterns associated with the Oregon policy met the “rational mechanism” expectations implicit to the policy. Study results identify some evidence that the policy yielded “rational mechanism” processes and outcomes, but also indicated that other mechanisms may have influenced implementation patterns and that the evidence of a link between policy and IMPACT OF STATE EVIDENCE-BASED PRACTICE MANDATE ii outcomes is a best inconsistent. Further research on evidence-based policies using definitional and measurement frameworks applied in this study is clearly warranted. IMPACT OF STATE EVIDENCE-BASED PRACTICE MANDATE iii

Impact of a State Evidence-Based Practice Legislative Mandate on County Practice Implementation Patterns and Inpatient Behavioral Health Discharge